How to Talk to Your Child About Mental Illness

I spent part of my childhood with a parent with mental illness. My father, who died by suicide when I was eight years old, struggled with bipolar illness for all of his adult life.

Until I started chronicling them, I thought I had very few memories of the part of my childhood that happened before my father died. In fact, I have many. I have a clear memory of my first grade teacher, Mrs. Jones. We, at six, thought she was 100 years old, and told her so. I remember sitting on carpet squares in second grade, getting stickers in third grade, learning to write in cursive. My family spent a lot of time on my father’s boat; most of my memories of the five of us together are of times on the boat, or summer weekends grilling on our back patio. I remember warm evenings playing outside with my brother and sister.

I have very few memories of my father as a person who lived with depression. The manic part of bipolar is more memorable. As I learned more about bipolar illness as an adult, aspects of my father’s life became more than just memories. This understanding helped me organize some of my father’s realities and helped me think about what parts of his life were truly him and what parts were expressions of his illness.

For years, I thought that my father’s suicide was his only attempt. It was only in the past couple of years that my mother told me that he had attempted suicide before. As I took in this new detail, I added something to the picture of my father I’d been painting in my mind since his death. The memory I have that is most clearly related to my father’s illness - his inpatient psychiatric hospitalization - made much more sense. If he had attempted suicide, of course he would be hospitalized.

One of the reasons my father’s hospitalization stands out in my mind is that it was one of the few things I talked about with other people when I was a child. I remember coming home from visiting him at the hospital and being asked by a neighbor where we’d been. I said, as any child would, the truth: “We were visiting Daddy in the hospital.”

It wasn’t a hospital visit like other hospital visits, though, something I would not know at such a young age. My father didn’t have a physical illness, he hadn’t been in a car accident. So, the answer to “Why is your dad in the hospital?” was quite complicated.

To be honest, I don’t know how I answered. I don’t remember that part. What I do remember is that it seemed entirely unacceptable to talk about it, to say out loud: “We were visiting Daddy in the hospital because he has a mental illness.” As may be obvious as you read these words, there are a few of them that just weren’t in my vocabulary.

If my father hadn’t died, I don’t know how we would have talked about his illness as a family. But, it’s something I think about more and more these days, especially after being asked by a friend struggling with mental illness how to talk about it with his child.

For a long time, I’ve wished that I knew more about what was really going on so that I didn’t have to write my own story of those years of my father’s life, piecing together details over a 25-year span. And, there’s a good evidence base backing up my hunch that it’s important to give children information about the reality of a parent’s illness: Those who study the impact of parental illness on children suggest that talking honestly with children helps establish trust so that, together, a family can cope with the illness’s impact on their lives.

When children aren’t given information, they fill in the blanks - something I certainly did. Talking openly is an opportunity to correct misconceptions and decrease the anxiety that comes with uncertainty.

But, how do you talk openly about something as complicated and misunderstood as mental illness? Within a family, there may be varying ideas about the causes of mental illness, feelings about treatments and their effectiveness, or fears about what will happen if something is said out loud.

I recently had the opportunity to hear Dr. Christine Wittman, an expert in talking with children of parents with cancer, share her perspective on how to talk with children about a parent’s illness. There are several ideas that are transferable from the realm of physical illness to the realm of mental illness:

- Balance an understanding of your child’s temperament with his or her developmental stage. A child who’s more reserved will need a different approach than a child who’s more impulsive. A younger child has ideas about what being “sick” means based on their own experiences of illness, so being concrete is even more important. An older adolescent can use information to make decisions about his or her own life. All of these “differentials” are considerations.

- Be flexible about how and when a conversation takes place. Some children will be more able to talk or ask questions while playing, while others will want to sit down and be face-to-face.

- Allow for questions. One of Dr. Wittman’s ideas that I liked most is having a journal where a child can pose questions and a parent can offer answers. For a child old enough to read and write, it seems powerful to invite them to share things that they might not feel comfortable saying to a parent face-to-face - and to offer the same opportunity for a parent to say something that might be hard to vocalize.

- “I’m doing the best I can to get better.” These words are true for those fighting an illness like cancer, and true for those fighting an illness like depression. One of the hardest things to communicate to anyone about mental illness is its often-chronic nature. There are ebbs and flows. Treatments that work at one time may not be as effective under changed circumstances. But, having a child know that a parent wants to feel better is a way to instill hope and strength.

- Finally, as is so true for so much of parenting, ask for help. If you are the partner of someone struggling with mental illness, get help for yourself so that you can be there for your child. If you talk about what’s going on with others in your life, they can help you through the ebbs and flows and be an additional source of support for your child.

Talking with children about mental illness requires learning a new a set of parenting skills. It may push your limits at a time that is already challenging. But, the most important thing for your child to hear, even if it feels impossible to get the words exactly right, is that you love them - which is something you know how to do already.

My husband is bipolar. He was hospitalized years ago when our son was 4 and our daughter was 2. I had no one to talk to about it. He wasn't diagnosed bipolar at that time it would be another ten years before he was correctly diagnosed. For years he was diagnosed at major depressive.

I was always up front with our kids that he had a mental illness. This made my husband's family uncomfortable they wouldn't and still don't talk about it.
My own family told me to divorce him. I was alienated without support. I have spent many years educating myself fighting for his stability. Teaching my kids that their father is ill.

Thank you for your article. Years ago people weren't suppose to speak of cancer or pregnancy in public now we can. Hopefully someday mental illness with be spoken without shame and stigma.

Trish, thanks for your comment and for talking with your kids about your husband's mental illness. I agree with you wholeheartedly in the hope that some day mental illness will be as out in the open as other health issues.